Factors related to dyspnea in patients with heart failure

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Patmanee Taimpitak
Sunida Preechawong


Background: Dyspnea is a common symptom in patients with heart failure. Appropriate management congruent with age self-care, and social support could help patients manage dyspnea.

Objective: This study aimed to examine the factors associated with dyspnea in patients with heart failure.

Methods: The sample included 122 patients with heart failure who met the inclusion criteria from three tertiary care hospitals. Data were collected using a demographic questionnaire, illness perception questionnaire, attitudes control questionnaire, social support questionnaire, self-care questionnaire, and dyspnea questionnaire. The Cronbach’s alpha coefficients of the related variables were .70, .81, .82, .79, and .96 respectively. The data were analyzed using descriptive statistics and Pearson’s product moment correlation coefficient.

Results: The results showed that the participants were male (66.4%)-and their average age were 52.25 years (SD=6.29). The mean score of dyspnea was at a low level (M=19.49; SD=23.88). Illness perception was positively statistically significant related to dyspnea in patients with heart failure (r = .336), while perceived control was negatively statistically significant related to dyspnea in patients with heart failure (r = -.291). Age, social support, and self-care were not significantly related to dyspnea in patients with heart failure (r = .067, -.070, and -.031, p<.05) respectively.

Conclusions: Health care team should consider patients’ illness perception and perceived control when developing effective interventions for patients with heart failure. This will help patients reduce dyspnea.


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Taimpitak ภ., & Preechawong ส. (2021). Factors related to dyspnea in patients with heart failure. JOURNAL OF HEALTH SCIENCE RESEARCH, 15(3), 107–119. Retrieved from https://he01.tci-thaijo.org/index.php/JHR/article/view/251641
นิพนธ์ต้นฉบับ (Original Articles)


Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart disease and stroke statistics-2021 Update: A report from the American Heart Association. Circulation. 2021;143(8): e254-e743. doi: 10.1161/CIR.0000000000000950.

Strategy and Planning Division. Summary of Illness reports 2019. [Internet]. 2020. [cited 2021 Jul 20]; Available from: http://dmsic.moph.go.th/index/detail/8317.

Reeder KM, Ercole PM, Peek GM, Smith CE. Symptom perceptions and self-care behaviors in patients who self-manage heart failure. J Cardiovasc Nurs. 2015; 30(1): E1-7. doi: 10.1097/JCN.0000000000000117.

Laothavorn P, Hengrussamee K, Kanjanavanit R, Moleerergpoom W, Laorakpongse D, Pachirat O, et al. Thai acute decompensated heart failure registry (Thai ADHERE). CVD Prevention and Control. 2010;5(3):89-95. doi: 10.1016/j.cvdpc.2010.06.001.

Kobkuechaiyapong S. Characteristics of heart failure patients readmitted within 28 days in Saraburi Hospital. The Journal of Prapokklao Hospital Clinical MedicalEducation Center. 2013;30(1):35-46. (in Thai).

Mentz RJ, Mi X, Sharma PP, Qualls LG, DeVore AD, Johnson KW, et al. Relation of dyspnea severity on admission for acute heart failure with outcomes and costs. Am J Cardiol. 2015;115(1):75-81. doi: 10.1016/j.amjcard.2014.09.048.

Ramasamy R, Hildebrandt T, O’Hea E, Patel M, Clemow L, Freudenberger R, et al. Psychological and social factors that correlate with dyspnea in heart failure. Psychosomatics. 2006;47(5):430-4. doi: 10.1176/appi.psy.47.5.430.

Huang TY, Moser DK, Hsieh YS, Gau BS, Chiang FT, Hwang SL. Moderating effect of psychosocial factors for dyspnea in Taiwanese and American heart failure patients. J Nurs Res. 2013;21(1):49-58. doi:10.1097/jnr.0b01 3e3182828d77.

Elizabeth R. Lenz LCP. The Theory of Unpleasant Symptoms. In: Smith MJ, Liehr PR, editors. Middle range theory for nursing. Third edition. New York: Springer Publishing Company; 2014. p.165-95.

Kupper N, Bonhof C, Westerhuis B, Widdershoven J, Denollet J. Determinants of dyspnea in chronic heart failure. J Card Fail. 2016;22(3):201-9. doi: 10.1016/j.cardfail. 2015.09.016.

Srihanoo P, Theeranut A. Illness representation among patients with acute exacerbation heart failure. Journal of Nursing and Health Care. 2018;36(3):89-98. (in Thai).

Roadstearn V, Kunsongkeit W, Duangpaeng S. Experiences of dyspnea in patients with heart failure. The Journal of Faculty of Nursing Burapha University. 2013;21(3):48-59. (in Thai).

Auld JP, Lee CS. Self-care moderates the relationship between dyspnea and quality of life. J. Card. Fail. 2016;22(8):S87. doi: 10.1016/j.cardfail.2016.06.279.

Jaarsma T, Arestedt KF, Martensson J, Dracup K, Stromberg A. The European heart failure self-care behaviour scale revised into a nine-item scale (EHFScB-9): a reliable and valid international instrument. Eur J Heart Fail. 2009;11(1):99-105. doi: 10.1093/eurjhf/hfn007.

Poungkaew A, Sindhu S, Pinyopasakul W, Tresukosol D, Viwatwongkasem C. Evaluation of a health service system for heart failure management in Thailand. Suranaree Journal of Science and Technology. 2018;25(3):295-306. (in Thai).

Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60(6):631-7. doi: 10.1016/j.jpsychores.2005.10.020.

Wongkuan D. Factors predicting sleep disturbances in acute myocardial infraction survivors. [Thesis]. Bangkok: Chulalongkon University; 2017. (in Thai).

Moser DK, Riegel B, McKinley S, Doering LV, Meischke H, Heo S, et al. The control attitudes scale-revised: psychometric evaluation in three groups of patients with cardiac illness. Nurs Res. 2009;58(1):42-51. doi: 10.1097/NNR.0b013e3181900ca0.

Buarapha S. Relationships between personal factor, perception of symptoms severity, self-efficacy, social support, and physical activity in patients with chronic heart failure. [Thesis]. Bangkok: Chulalongkon University; 2004. (in Thai).

Kheawwan P. Relationships between physiological, psychological, situational factors, and dyspnea of post opened-heart surgery patients receiving mechanical ventilator. [Thesis]. Bangkok: Chulalongkon University; 2003. (in Thai).

Turan GB, Tan M. Analysis of the factors affecting illness perception in patients with heart failure. Pak Heart J. 2018;51 (2):131–8. doi: 10. 47144/phj.v51i2.1493.

Doering LV, Chen B, Deng M, Mancini D, Kobashigawa J, Hickey K. Perceived control and health-related quality of life in heart transplant recipients. Eur J Cardiovasc Nurs. 2018;17(6):513-20. doi: 10.1177/1474515117749225.

Infurna FJ, Gerstorf D. Perceived control relates to better functional health and lower cardio-metabolic risk: The mediating role of physical activity. Health Psychol. 2014;33(1):85-94. doi: 10.1037/ a0030208.

Heart Failure Council of Thailand (HFCT) 2019 heart failure guideline. [Internet]. 2019 [cited 2021 Jun 30]; Available from: http://www.thaiheart.org. (in Thai).